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1、氯毗格雷联合低分了肝索钠治疗进展性缺血性脑卒屮疗效观察[摘要]目的:观察氯毗格雷联合低分了肝素钠治疗进展性缺血性脑卒屮的疗效。方法:选择135例发病在12-48h,病情呈进行性加重的进展性缺血性脑卒中患者,随机分为三纟fl,分别接受低分了肝索钠治疗、氯毗格雷治疗、氯毗格雷和低分了肝索钠联合治疗。1个疗稈后进行疗效判定,并监测治疗前后血液流变学的变化。结果:1个疗程后低分子肝素钠组总有效率为82.2%、联合用药组总有效率为93.3%,均明显高于氯毗格雷组的73.3%,而且治疗前麻血液流变学的变化亦
2、有显著性差异,联合用药纟R总有效率最高和血流变学变化最明显,同时未发现出血倾向等不良反应。结论:低分了肝素能有效治疗进展性缺血性脑卒屮,与氯毗格雷联合使用具有协同作用,临床疗效确切、安全。[关键词]氯毗格雷;低分子肝素钠;缺血性脑卒屮;联合[屮图分类号]R743・33[文献标识码]C[文章编号11673-7210(2009)05(a)-087-02TheobservationofcurativeeffectofClopidogrelhydrogensuifatecombinedwithLowmo
3、lecularheparinintreatingprogressivecerebralarterialthrombosisWIJYong,LIANGYan,HUANGDandan,LUChangsheng(ThePeople'shospitalofGaozhoucounty,GuangdongProvince,Gaozhou525200,China)[Abstract]Objective:ToobservethecurativeeffectofClopidogrelhydrogensulfate
4、combinedwithLowmolecularheparinintreatingprogressivecerebralarterialthrombosis.Methods:Weselected135casesofprogressivecerebralarterialthrombosishappenedfrom12hoursto48hours,anddistributedinto3groupsrandomly.WeusedLowmolecularheparin、Clopidogrelhydrog
5、ensulfate>ClopidogrelhydrogensulfatecombinedwithLowmolecularheparinseparatelytotreateit.Results:Afteronecourseoftreatment,totaleffectiverateofLowmolecularheparinandClopidogrelhydrogensulfatecombinedwithLowmolecularheparinwere82.2%and93.3%separately,m
6、uchhigherthantotaleffectiverateofClopidogrelhydrogensulfate(73・概).Thechangeofthebloodhemorrheologybeforeandaftertreatmentwasdetermined・InthegroupoftreatingwithClopidogrelhydrogensulfatecombincdwithLowmolecularheparinwehadthehighertotaleffectiveratean
7、dmucheviclentchangeofthebloodhemorrheologythantheothergroups,andtheadverseeffecthemorrhagictenclencydidrftfound.Conelusion:Lowmolecularheparinhaseffectivetherapyonprogressivecerebralarterialthrombosis,whileClopidogrelhydrogensulfatecombinedwithLowmol
8、ecularheparinhasthesynergisticeffect,andtheclinictherapeuticeffectisidentifyandsafetv.[Keywords]Clopidogrelhydrogensulfate;Lowmolecularheparin;Cerebralarterialthrombosis;Combination缺血性脑血管疾病占•所有脑血管疾病的70%〜85%,致残和致死率均较高,溶栓治疗已被认为是最有效的方法,但有很多局限性,在基层医院和交通不